Self-contained portable positionable oscillating motor array system

ABSTRACT

In some embodiments, a system may include an inner wearable harness worn, during use, on a torso of a subject. The system may include a plurality of engines which when activated apply an oscillation force. The system may include a positioning system which allows positioning at least one of the plurality of engines on the inner wearable system such that the oscillation force is applied to at least one treatment area of the subject. The oscillation force may mobilize, during use, at least some secretions in an airway within the subject substantially adjacent the treatment area. The system may include an outer harness worn, during use, on a torso of a subject. The outer wearable harness, when activated, adjusts the oscillation force applied by at least some of the activated plurality of engines to the treatment area.

PRIORITY CLAIM

This application is a continuation of U.S. patent application Ser. No.14/876,472 entitled “SELF-CONTAINED PORTABLE POSITIONABLE OSCILLATINGMOTOR ARRAY” filed on Oct. 6, 2015, which claims priority to U.S.Provisional Patent Application No. 62/060,772 entitled “CHEST WALLOSCILLATION VEST” filed on Oct. 7, 2014, U.S. Provisional PatentApplication No. 62/101,131 entitled “SELF-CONTAINED PORTABLE HIGHFREQUENCY PHYSIOLOGICAL OSCILLATOR” filed on Jan. 8, 2015, and U.S.Provisional Patent Application No. 62/183,819 entitled “SELF-CONTAINEDPORTABLE POSITIONABLE OSCILLATING MOTOR ARRAY” filed on Jun. 24, 2015,all of which are incorporated by reference herein.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present disclosure generally relates to respiratory therapies. Moreparticularly, the disclosure generally relates to a method and systemfor high frequency upper chest wall oscillation therapy.

2. Description of the Relevant Art

Subjects who are unable to mobilize their own lung secretions withoutassistance (subjects with, for example, chronic obstructive pulmonarydisease (COPD)) are exceedingly common, which together account for over1 million hospitalizations each year in the United States alone. Betaagonists, anti-cholinergics, and corticosteroids delivered inaerosolized forms are recommended in the treatment of COPD. Thesemedications rely on deposition into distal airspaces to suppress airwayinflammation or promote bronchodilation. Excessive mucous production andimpaired airway mucociliary clearance can lead to airway plugging, andthereby reduce the deposition of and response to aerosolizedmedications. These considerations highlight the need for therapies thatclear airways of mucus in the acute management of diseases such ascystic fibrosis, bronchiectasis (and other severe form of COPD), andcertain neuromuscular diseases.

Manual percussion techniques of chest physiotherapy have been used for avariety of diseases, such as cystic fibrosis, emphysema, and chronicbronchitis, to remove excess mucus that collects in the lungs. To bypassdependency on a caregiver to provide this therapy, chest compression andoscillation devices have been developed to produce High Frequency ChestWall Oscillation (HFCWO), a very successful method of airway clearance.High frequency chest wall oscillation (HFCWO) creates high velocity, lowamplitude oscillation energy when applied through a vest worn over thethorax, and is used for airway mucus clearance in patients with cysticfibrosis, bronchiectasis, and neuromuscular disorders. Studies inpatients with cystic fibrosis suggest that HFCWO applied via a vest isas effective as other modes of airway mucus clearance, includinghand-held devices (e.g., flutter devices) and conventional chestphysiotherapy. HFCWO offers the advantage that it can be performed inacutely ill patients who may be unable to use hand-held deviceseffectively, such as early in the course of hospitalization. Moreover,HFCWO can be performed without the assistance from trained health carepersonnel, and may therefore offer a practical advantage compared tochest physiotherapy.

Professional healthcare environments are required to constantly bevigilant regarding sanitation and cross contamination between patients.To this end medical equipment must be sanitized before being used again.However, sanitizing equipment is typically time consuming and/orexpensive. As such much of the equipment used in healthcare environmentswhich comes into direct contact with subjects is disposable (or coveredby disposable sheaths). It is typically much easier and/or lessexpensive to throw away equipment which comes into contact with subjectsas opposed to cleaning the equipment.

As such, it may advantageous to form a wearable HFCWO system with one ormore disposable portions.

SUMMARY

In some embodiments, a system and/or method may include an innerwearable harness worn, during use, on a torso of a subject. The systemmay include a plurality of engines which when activated apply anoscillation force to at least one treatment area of the subject. Atleast some of the plurality of engines may be releasably couplable tothe inner wearable harness. The system may include a positioning systemwhich allows positioning at least one of the plurality of engines suchthat the oscillation force is applied to at least one of the treatmentareas of the subject. The oscillation force may mobilize, during use, atleast some secretions in an airway within the subject substantiallyadjacent the treatment area. The system may include an outer harnessworn, during use, on a torso of a subject. The outer wearable harness,when activated, adjusts the oscillation force applied by at least someof the activated plurality of engines to the treatment area.

BRIEF DESCRIPTION OF THE DRAWINGS

Advantages of the present invention may become apparent to those skilledin the art with the benefit of the following detailed description of thepreferred embodiments and upon reference to the accompanying drawings.

FIG. 1 depicts a front perspective view of a representation of anembodiment of a portable high frequency chest wall oscillator system.

FIG. 2 depicts a front view of a representation of an embodiment of apair of human lungs.

FIG. 3 depicts a front perspective view of a representation of anembodiment of a portable high frequency chest wall oscillator harness.

FIG. 4A depicts a front view of a representation of an embodiment of anengine coupling system.

FIG. 4B depicts a side view of a representation of an embodiment of anengine coupling system.

FIG. 5 depicts a front perspective view of a representation of anembodiment of a portable high frequency chest wall oscillator harnessusing a hook and loop coupling system positioned on a subject.

FIG. 6 depicts a front perspective view of a representation of anembodiment of a portable high frequency chest wall oscillator harnessusing sealable containers coupling system positioned on a subject.

FIG. 7 depicts a representation of an embodiment of a portable highfrequency physiological oscillator harness positioned around a subject'sneck.

FIG. 8 depicts a representation of an embodiment of a portable highfrequency physiological oscillator harness positioned around a subject'sneck in combination with portable high frequency chest wall oscillatorvest.

FIGS. 9A-J depict representations of different areas of a subject'slungs which may require treatment using herein described systems andmethods.

FIG. 10 depicts a front view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness positionedon a subject.

FIG. 11 depicts a rear view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness positionedon a subject.

FIG. 12 depicts a front view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness positionedon a subject.

FIG. 13 depicts a rear view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness positionedon a subject.

FIG. 14 depicts a front view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness and an outerharness positioned on a subject.

FIG. 15 depicts a rear view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness and an outerharness positioned on a subject.

FIG. 16 depicts a front view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness.

FIG. 17 depicts an interior view of a representation of an embodiment ofa portable high frequency chest wall oscillator inner harness laid outin an open flat presentation.

FIGS. 18A-B depict a first and a second opposing side view of arepresentation of a first embodiment of an engine.

FIG. 18C depicts a side view of a representation of a second embodimentof an engine.

FIG. 19 depicts a front view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness includingunsecured fasteners positioned on a subject.

FIG. 20 depicts a front view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness includingsecured fasteners as well as an inactivated outer harness positioned ona subject.

FIG. 21 depicts a front view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness includingsecured fasteners as well as a single activated outer harness positionedon a subject.

FIG. 22 depicts a front view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness includingsecured fasteners as well as two inactivated outer harnesses positionedon a subject.

FIG. 23 depicts a front view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness includingsecured fasteners as well as two activated outer harnesses positioned ona subject.

FIG. 24 depicts a front view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness includingsecured fasteners as well as two inactivated outer harnesses positionedon a subject.

FIG. 25 depicts a front view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness includingsecured fasteners as well as two activated outer harnesses positioned ona subject.

FIG. 26 depicts a front view of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness includingsecured fasteners as well as two activated outer harnesses positioned ona subject.

While the invention is susceptible to various modifications andalternative forms, specific embodiments thereof are shown by way ofexample in the drawings and may herein be described in detail. Thedrawings may not be to scale. It should be understood, however, that thedrawings and detailed description thereto are not intended to limit theinvention to the particular form disclosed, but on the contrary, theintention is to cover all modifications, equivalents and alternativesfalling within the spirit and scope of the present invention as definedby the appended claims.

The headings used herein are for organizational purposes only and arenot meant to be used to limit the scope of the description. As usedthroughout this application, the word “may” is used in a permissivesense (i.e., meaning having the potential to), rather than the mandatorysense (i.e., meaning must). The words “include,” “including,” and“includes” indicate open-ended relationships and therefore meanincluding, but not limited to. Similarly, the words “have,” “having,”and “has” also indicated open-ended relationships, and thus mean having,but not limited to. The terms “first,” “second,” “third,” and so forthas used herein are used as labels for nouns that they precede, and donot imply any type of ordering (e.g., spatial, temporal, logical, etc.)unless such an ordering is otherwise explicitly indicated. For example,a “third die electrically connected to the module substrate” does notpreclude scenarios in which a “fourth die electrically connected to themodule substrate” is connected prior to the third die, unless otherwisespecified. Similarly, a “second” feature does not require that a “first”feature be implemented prior to the “second” feature, unless otherwisespecified.

Various components may be described as “configured to” perform a task ortasks. In such contexts, “configured to” is a broad recitation generallymeaning “having structure that” performs the task or tasks duringoperation. As such, the component can be configured to perform the taskeven when the component is not currently performing that task (e.g., aset of electrical conductors may be configured to electrically connect amodule to another module, even when the two modules are not connected).In some contexts, “configured to” may be a broad recitation of structuregenerally meaning “having circuitry that” performs the task or tasksduring operation. As such, the component can be configured to performthe task even when the component is not currently on. In general, thecircuitry that forms the structure corresponding to “configured to” mayinclude hardware circuits.

Various components may be described as performing a task or tasks, forconvenience in the description. Such descriptions should be interpretedas including the phrase “configured to.” Reciting a component that isconfigured to perform one or more tasks is expressly intended not toinvoke 35 U.S.C. §112 paragraph (f), interpretation for that component.

The scope of the present disclosure includes any feature or combinationof features disclosed herein (either explicitly or implicitly), or anygeneralization thereof, whether or not it mitigates any or all of theproblems addressed herein. Accordingly, new claims may be formulatedduring prosecution of this application (or an application claimingpriority thereto) to any such combination of features. In particular,with reference to the appended claims, features from dependent claimsmay be combined with those of the independent claims and features fromrespective independent claims may be combined in any appropriate mannerand not merely in the specific combinations enumerated in the appendedclaims.

It is to be understood the present invention is not limited toparticular devices or biological systems, which may, of course, vary. Itis also to be understood that the terminology used herein is for thepurpose of describing particular embodiments only, and is not intendedto be limiting. As used in this specification and the appended claims,the singular forms “a”, “an”, and “the” include singular and pluralreferents unless the content clearly dictates otherwise. Thus, forexample, reference to “a linker” includes one or more linkers.

DETAILED DESCRIPTION Definitions

Unless defined otherwise, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art.

The term “compression” as used herein generally refers to theapplication of balanced inward (e.g., “pushing”) forces to differentpoints on a material or structure.

The term “connected” as used herein generally refers to pieces which maybe joined or linked together.

The term “coupled” as used herein generally refers to pieces which maybe used operatively with each other, or joined or linked together, withor without one or more intervening members.

The term “directly” as used herein generally refers to one structure inphysical contact with another structure, or, when used in reference to aprocedure, means that one process effects another process or structurewithout the involvement of an intermediate step or component.

The term “engine” as used herein generally refers to a machine designedto convert one form of energy into mechanical energy (e.g., electricmotors, sonic wave generators, etc.).

The phrase “oscillation force” as used herein generally refers to avibrational force, or a vibrational wave effect or wave form.

The term “pressure” as used herein generally refers to a force appliedsubstantially perpendicular to a surface of an object.

Portable High Frequency Physiological Oscillator

Chest physiotherapy with bronchial drainage is a known treatment formobilization and removal of airway secretions in many types ofrespiratory dysfunction especially in chronic lung disease (e.g., cysticfibrosis, brochiectasis, bronchitis, primary ciliary dyskinesiasyndrome). Chest physiotherapy has been demonstrated to be effective inmaintaining pulmonary function and prevention or reduction ofrespiratory complications in patients with chronic respiratory diseases.In some embodiments, a system and/or method may include clearing abiological airway. Biological airways may include any portion of therespiratory system including, but not limited to, trachea, bronchi,bronchioles, and alveoli.

The method may include positioning a wearable system on a subject. Themethod may include adjusting the wearable system such that anoscillation force is applied to at least a first zone and to at least asecond zone of the subject (e.g., and possibly more zones). In someembodiments, an oscillation force may include a vibrational force, or avibrational wave effect or wave form.

FIG. 1 depicts a front perspective view of a representation of anembodiment of a portable high frequency chest wall oscillator system100. Known HFCWO systems do not allow for a user adjusting where forcesare applied to on the subject. This is problematic because although someknown HFCWO systems may come in different sizes to accommodatedifferently sized subjects, there are far too many people of differentsizes and so it is impractical to produce enough differently sizedsystems for all of the differently sized subjects. FIG. 2 depicts afront view of a representation of an embodiment of a pair of human lungs200. Known HFCWO systems may typically apply forces at zones 210 a-b. Asystem 100 may allow for adjusting where forces are applied to thesubject, for example, to what are identified as at least the first zone220 a and the second zone 220 b. Applying high frequency forces to zones220 as opposed to zones 210 may allow for greater remediation ofsymptoms associated with certain forms of chronic lung disease.

In some embodiments, the first zone 220 a may be proximate to and belowa collarbone of the subject (e.g., as depicted in FIG. 2). FIG. 2depicts a front view of a representation of an embodiment of a pair ofhuman lungs 200. In some embodiments, the second zone 220 b may bepositioned below first zone and proximate to and above a bottom of a ribcage of the subject (e.g., as depicted in FIG. 2). In some embodiments,the first and/or second zone may be positioned relative to any relevantmarkers (e.g., one or more of the subject's physiological markers) whichresults in increased mobilization of secretions in an airway within thesubject. The method may include applying a force (e.g., an oscillationforce, a high frequency force, a pneumatic force, etc.) to the firstzone and/or the second zone (e.g., and possibly additional zones) usinga first engine 110 a and a second engine 110 b respectively. The methodmay include mobilizing secretions in an airway within the subject (e.g.,substantially adjacent the first and/or second zone). In someembodiments, an engine may include electric motors, sonic wavegenerators, etc.

In some embodiments, mobilizing secretions may include generatingincreased airflow velocities and/or percussive or oscillation forcesresulting in cough-like shear forces. In some embodiments, mobilizingsecretions may include decreasing a viscosity of at least somesecretions in an airway within the subject substantially adjacent thefirst and/or second zone. Mobilizing secretions may assist subjects tomove retained secretions from smaller airways to larger airways wherethey may move more easily via coughing. In some embodiments, secretionsmay include what is generally referred to as mucus. Mucus may includewater, ions, soluble mediators, inflammatory cells, and/or secretedmucins. In some embodiments, secretions may include any fluids (e.g.,excessive fluids) potentially blocking subject airways.

In some embodiments, adjusting the wearable system may include adjustingfastening systems which couple the wearable system to the subject. Insome embodiments, the wearable system may be adjustable at least acrossa chest and/or portion of a torso of a subject (e.g., as depicted inFIG. 1 using friction fittings and straps 120). In some embodiments, thewearable system may be adjustable at least across one or more shouldersof a subject (e.g., as depicted in FIG. 1). In some embodiments, thewearable system may be adjustable using one or more fasteners 130 usingat least one type of fastener. In some embodiments, adjusting thewearable system may include positioning the first engine or the secondengine (e.g., and possibly additional engines) relative to the firstzone or the second zone (e.g., and possibly additional zones)respectively. In some embodiments, a fastener may include a plurality ofsnaps 130 coupling the wearable system across the shoulder of a subject(e.g., as depicted in FIG. 1) such that the engines may positionedappropriately relative to the airways of the subject. By attaching thefasteners in different combinations with one another the engines may beadjusted relative to the subject.

In some embodiments, engines may be repositioned or adjusted relative toa subject using a system (e.g., by a doctor) which inhibits a subjectfrom repositioning the engines once positioned. For example, a wearablegarment may include a plurality of pockets or containers which enginesmay be positioned in and then sealed in. FIG. 6 depicts a frontperspective view of a representation of an embodiment of a wearablesystem 100 using a plurality of sealable containers 190 coupling systemused to couple the engines to the wearable system.

In some embodiments, the system may include a wearable system (e.g., asdepicted in FIG. 1) which resembles a vest (e.g., coupled or directlyattached at least across a front, side, and/or back). In someembodiments, the system may include a wearable system which includes aplurality of bands and/or straps 160 (e.g., as depicted in FIG. 3). FIG.3 depicts a front perspective view of a representation of an embodimentof a portable high frequency chest wall oscillator harness 100. In someembodiments, the bands 160 (e.g., as depicted in FIG. 3) may beincorporated into a vest (e.g., as depicted in FIG. 1). The engines 110a-d may be coupled or directly attached to the bands. The engines may becoupled or directly attached to the bands such that the engines arepositionable along the bands. The bands may include vertical bands 160 aand horizontal bands 160 b. Positionable engines may allow the enginesto be positioned appropriately to provide the greatest benefit to thesubject.

The engines may be positionally coupled or directly attached to thebands and/or system using a number of means known such that the enginesmay be repositioned during use as appropriate for individual subjects.In some embodiments, a hook and loop system may be used to couple theengines to a wearable system such that the engines are repositionable.FIG. 5 depicts a front perspective view of a representation of anembodiment of a wearable system 100 using a hook and loop system tocouple engines 100 to the system. In some embodiments, a cleat 170 maybe used to couple the engine to one or more of the bands. FIG. 4Adepicts a front view of a representation of an embodiment of an enginecoupling system 170. FIG. 4B depicts a side view of a representation ofan embodiment of an engine coupling system 170. The cleat may include alocking mechanism 180 which once locked may inhibit movement of thecleat along the band(s). In some embodiments, a coupling mechanism maycouple a horizontal band 160 b to a vertical band 160 a such thatengines are repositioned relative to the subject by repositioning thebands relative to one another. The bands may include coupling mechanismsas depicted in FIG. 1 in order to couple the bands to a subject. Thelengths of the bands may be adjustable as well in order to fit the bandsto the subject.

In some embodiments, the wearable system 100 may include multipleengines 110 (e.g., eight or more engines). The system may include atleast four engines 110, at least six engines 110, or at least eightengines 110 (e.g., as depicted in FIG. 1, although only the front fourare depicted, the remaining four are on the back of the system 100). Insome embodiments, the system may include eight engines. In someembodiments, adjusting the wearable system may include positioning athird engine or a fourth engine relative to the first zone or the secondzone respectively on an opposing side of the subject opposite of theside of the first and the second engine.

In some embodiments, the system 100 may include a control unit 140. Themethod may include activating at least the first engine using thecontrol unit 140. The control unit may controlactivation/deactivation/adjustment of all of the engines of the system100. In some embodiments, the control unit 140 may be couplable to thesystem 100 (e.g., using a flap of material which may be used to coverand protect the control unit as depicted in FIG. 1). The control unit140 may be directly wired to the engines 110 and/or may be wirelesslycoupled or directly attached to the engines. The control unit may useany number of known input methods (e.g., including touchpad). Thecontrol unit may be digital or analog. In some embodiments, the controlunit may adjust one or more settings of the engines. The control unitmay adjust the oscillation force output by the engine. The control unitmay adjust an amplitude of the oscillation force output by the engine.The control unit may adjust a frequency of the oscillation force outputby the engine. In some embodiments, engine parameters may be adjustedvia software (e.g., a phone app) remotely (e.g., Wi-Fi, Bluetooth,etc.). In some embodiments, the engines 110 may include a frequencyrange from 5 Hz to 20 Hz. In some embodiments, the intensity levelsdictate the frequency which generally runs at 5 Hz for the lowestsetting, 13 Hz for the medium setting and 20 Hz for the highest setting.

In some embodiments, a method may include modifying the treatmentparameters (e.g. amplitude, frequency, and time for each engine). Eachengine may be programmed, using physical hardware control unit orsoftware to run a custom cycle. This programming may be performed by thesubject. In addition, the system may provide a physician or caregiverwith the ability to prescribe a defined treatment and to inhibit theuser from modifying the treatment settings (e.g. lock-out featurew/password, pin code, etc.).

In some embodiments, the method and/or system may adaptively modify thetreatment protocol based on subject and/or physician feedback. Forexample, a subject enters mucus secretion levels after each treatmentand the system adaptively optimizes the treatment settings over time.

In some embodiments, the method and/or system may monitor compliance foreach subject, including parameters run, time of treatment, information.For example, the system could monitor (in real-time) the treatment timeof day and any subject feedback. This could be accomplished throughhardware or software (e.g. a web-based subject/physician portal whichlinks w/Bluetooth to each vest). The information may be provided to thesubject, physician, insurance company or other third-party.

In some embodiments, the system 100 may include at least one battery150. The method may include powering at least the first engine 110 ausing one or more batteries 150 coupled or directly attached to thewearable system. In some embodiments, a battery 150 may include arechargeable battery and/or a disposable battery. The battery 150 mayinclude two or more batteries. The batteries 150 may be easily swappedout whether rechargeable or disposable. The battery 150 may be coupledor directly attached to the system 100 (e.g., using a flap of materialwhich may be used to cover and protect the battery as depicted in FIG.1). The system may include an adapter such that when necessary thesystem may be coupled or directly attached to an electrical outlet(e.g., through an electrical adapter if necessary). The system 100 maybe powered using AC or DC power sources such that the system may bepowered using virtually any known power source currently available.

In some embodiments, the system may be self-contained. The system may beself-contained such that a subject may wear the system 100 and movefreely and in a substantially unrestricted manner The system may beself-contained such that a subject may wear the system 100 whilefunctioning and not physically connected to any external devices (e.g.,air pumps).

Upper Chest Portable High Frequency Physiological Oscillator

In some embodiments, a system and/or method may include clearing abiological airway(s). As discussed though even wearable systems asdescribed herein may not be sufficient to assist a subject in fullyclearing the subject's biological airway. In some instances secretionsmay be moved out of the lungs but not high enough into the majorbronchial tubes and/or trachea such that a subject may evacuate thesecretions from the subject (especially with the reduced air capacity ofthe subject who need to employ systems as described herein). It would bebeneficial to have a system which works alone or in combination with thevest/harnesses described herein to further move a subject's secretionsout of the subject's airways.

In some embodiments, the method may include positioning a wearablesystem around a subject's neck. The wearable system may be coupled ordirectly attached to another wearable garment such that the wearablesystem is positioned substantially around at least a portion of thesubject's neck. The method may include adjusting the wearable systemsuch that an oscillation force is applied to at least an upper firstzone of the subject. The upper first zone may be proximate to acollarbone of the subject and proximate to a juxtaposition of thesubject's bronchial tubes and trachea on a first side of the subject.The method may include applying the oscillation force to at least upperfirst zone using an upper first engine. The method may includemobilizing at least some secretions in an airway within the subjectsubstantially adjacent the first zone so that it may be expelled by thesubject.

FIG. 7 depicts a representation of an embodiment of a portable highfrequency physiological oscillator harness 300 positioned around asubject's neck 400. In some embodiments, the upper first engine 310 mayinclude one or more engines. The engines may be separately poweredand/or controlled. The upper first engine may include at least threeengines 310 a-c. In some embodiments, a first 310 a of the three enginesmay be positioned proximate a first bronchial tube 410 a extending fromthe juxtaposition. A second 310 b of the three engines may be positionedproximate a second bronchial tube 410 b extending from thejuxtaposition. A third 310 c of the three engines may be positionedproximate the trachea 420. Positioning at least one (e.g., three) enginein such a fashion may assist a subject in clearing secretions out of thesubject's airways, especially when used in combination with thevest/harness described herein. The vest/harness described herein mayassist in moving secretions from a subject's airways in the lungs upinto the at least major bronchial passages adjacent/in the upper firstzone wherein the wearable system may further move the subject'ssecretions out of the subject.

In some embodiments, the method may include adjusting the wearablesystem such that the oscillation force is applied to at least an uppersecond zone of the subject. The upper second zone may be proximate tothe collarbone of the subject and proximate to the juxtaposition of thesubject's bronchial tubes and trachea. The upper second zone may bepositioned on a second side of the subject, wherein the second side ison an opposing side of the subject from the first side. The method mayinclude applying the oscillation force to the at least upper second zoneusing an upper second engine. The upper second engine may include atleast one (e.g., three) engines.

In some embodiments, the wearable system 300 may include adjustablefastening systems 320 which couple the wearable system to the subject.Adjustable fastening systems may include snaps buckles, Velcro, etc.FIG. 8 depicts a representation of an embodiment of a portable highfrequency physiological oscillator harness positioned around a subject'sneck in combination with portable high frequency chest wall oscillatorvest. The wearable system 300 may be used in combination with othersystems which function to mobilize internal lung secretions. Thewearable system 300 may be used without any other systems in order tomobilize internal lung secretions such that the secretions are expelledout of the subject.

In some embodiments, the system 300 may include a control unit 140(e.g., a control unit of the system 300 may function independently ofother possible control units, a control unit of the system 300 may beelectrically coupled or directly attached to the control unit of thevest when used in combination with the vest, or the system 300 may notinclude an independent control unit and the system 300 may be coupled ordirectly attached into a control unit of a wearable system 100). Themethod may include activating at least the upper first engine using thecontrol unit 140. The control unit may controlactivation/deactivation/adjustment of all of the engines of the system300. In some embodiments, the control unit 140 may be couplable to thesystem 300 (e.g., using a flap of material which may be used to coverand protect the control unit). The control unit 140 may be directlywired to the engines 310 and/or may be wirelessly coupled or directlyattached to the engines. The control unit may use any number of knowninput methods (e.g., including touchpad). The control unit may bedigital or analog. In some embodiments, the control unit may adjust oneor more settings of the engines. The control unit may adjust theoscillation force output by the engine. The control unit may adjust anamplitude of the oscillation force output by the engine. The controlunit may adjust a frequency of the oscillation force output by theengine. In some embodiments, engine parameters may be adjusted viasoftware (e.g., a phone app) remotely (e.g., Wi-Fi, Bluetooth, etc.). Insome embodiments, the engines 310 may include a frequency range from 5Hz to 20 Hz. In some embodiments, the intensity levels dictate thefrequency which generally runs at 5 Hz for the lowest setting, 13 Hz forthe medium setting and 20 Hz for the highest setting.

In some embodiments, a method may include modifying the treatmentparameters (e.g. amplitude, frequency, and time for each engine). Eachengine may be programmed, using physical hardware control unit orsoftware to run a custom cycle. This programming may be performed by thesubject. In addition, the system may provide a physician or caregiverwith the ability to prescribe a defined treatment and to inhibit theuser from modifying the treatment settings (e.g. lock-out featurew/password, pin code, etc.).

In some embodiments, the method and/or system may adaptively modify thetreatment protocol based on subject and/or physician feedback. Forexample, a subject enters mucus secretion levels after each treatmentand the system adaptively optimizes the treatment settings over time.

In some embodiments, the method and/or system may monitor complianceinformation. For example, the system could monitor (in real-time) thetreatment for each subject, including parameters run, time of treatment,time of day and any subject feedback. This could be accomplished throughhardware or software (e.g. a web-based subject/physician portal whichlinks w/Bluetooth to each vest). The information may be provided to thesubject, physician, insurance company or other third-party.

In some embodiments, the system 300 may include at least one battery 150(e.g., a battery of the system 300 may function independently of otherpossible batteries, a battery of the system 300 may be electricallycoupled or directly attached to the battery of the vest when used incombination with the vest, or the system 300 may not include anindependent battery and the system 300 may be coupled or directlyattached into a battery of a wearable system 100). The method mayinclude powering at least the upper first engines 310 using one or morebatteries 150 coupled or directly attached to the wearable system. Insome embodiments, a battery 150 may include a rechargeable batteryand/or a disposable battery. The battery 150 may include two or morebatteries. The batteries 150 may be easily swapped out whetherrechargeable or disposable. The battery 150 may be coupled or directlyattached to the system 300 (e.g., using a flap of material which may beused to cover and protect the battery). The system may include anadapter such that when necessary the system may be coupled or directlyattached to an electrical outlet (e.g., through an electrical adapter ifnecessary). The system 300 may be powered using AC or DC power sourcessuch that the system may be powered using virtually any known powersource currently available.

In some embodiments, the system may be self-contained. The system may beself- contained such that a subject may wear the system 300 and movefreely and in a substantially unrestricted manner The system may beself-contained such that a subject may wear the system 300 whilefunctioning and not physically connected to any external devices (e.g.,air pumps).

Positionable Oscillating Motor Array with Potentially Disposable and/orRecyclable Portions

In some embodiments, it is advantageous to form a wearable system withone or more disposable portions. There are many advantages to having awearable system formed from at least in part disposable portionsincluding facilitating use of the wearable system in differentenvironments (e.g., hospitals, clinics, etc.). Professional healthcareenvironments are required to constantly be vigilant regarding sanitationand cross contamination between patients. To this end medical equipmentmust be sanitized before being used again. However, sanitizing equipmentis typically time consuming and/or expensive. As such much of theequipment used in healthcare environments which comes into directcontact with subjects is disposable (or covered by disposable sheaths).It is typically much easier and/or less expensive to throw awayequipment which comes into contact with subjects as opposed to cleaningthe equipment.

The method may include positioning a wearable system on a subject. Themethod may include adjusting the wearable system such that anoscillation force is applied to at least a first zone and to at least asecond zone of the subject (e.g., and possibly more zones). In someembodiments, the oscillation force may be infinitely adjustable relativeto the subject. Having an infinitely adjustable oscillation force (e g ,infinitely positionable engines) may allow customizable positioning ofthe oscillation force as required by the subject (e.g., as prescribed bya care giver (e.g., doctor, nurse, etc.).

In some embodiments, mobilizing secretions may include generatingincreased airflow velocities and/or percussive or oscillation forcesresulting in cough-like shear forces. In some embodiments, mobilizingsecretions may include decreasing a viscosity of at least somesecretions in an airway within the subject substantially adjacent thefirst and/or second zone. Mobilizing secretions may assist subjects tomove retained secretions from smaller airways to larger airways wherethey may move more easily via coughing. In some embodiments, secretionsmay include what is generally referred to as mucus. Mucus may includewater, ions, soluble mediators, inflammatory cells, and/or secretedmucins. In some embodiments, secretions may include any fluids (e.g.,excessive fluids) potentially blocking subject airways.

Depending upon the subject's specific condition one or more engines maybe positioned accordingly (e.g., around the area of trouble for thesubject which require treatment). FIGS. 9A-J depict representations ofdifferent areas of a subject's lungs 510 a-b which may require treatmentusing herein described systems and methods. FIGS. 9A-J depictrepresentations of right lung 510 a and left lung 510 b of subject 500.Zones 520 of lungs 510 are examples of areas in a subject which may needtreatment and/or wherein treatment may be applied as prescribed by aphysician for treatment. FIGS. 9A-J depict representations of subject500 positioned for extracting fluids from lungs 510 using knownpercussion methods. In some embodiments, positioning the subject 500, asdepicted in FIGS. 9A-J for example, may be used in combination with thesystems and methods described herein. In some embodiments, any specialpositioning of the subject may not be necessary and/or used incombination with the systems and methods described herein. FIG. 9Adepicts subject 500 positioning and/or zones 520 for treating (e.g.,applying oscillation forces using systems and methods described herein)respiratory afflictions affecting the left and right anterior apicalportions of lungs 510. FIG. 9B depicts subject 500 positioning and/orzones 520 for treating (e.g., applying oscillation forces using systemsand methods described herein) respiratory afflictions affecting the leftand right posterior apical portions of lungs 510. FIG. 9C depictssubject 500 positioning and/or zones 520 for treating (e.g., applyingoscillation forces using systems and methods described herein)respiratory afflictions affecting the left and right anterior segmentsof lungs 510. FIG. 9D depicts subject 500 positioning and/or zones 520for treating (e.g., applying oscillation forces using systems andmethods described herein) respiratory afflictions affecting the rightmiddle lobe portion of lung 510. FIG. 9E depicts subject 500 positioningand/or zones 520 for treating (e.g., applying oscillation forces usingsystems and methods described herein) respiratory afflictions affectingthe left singular portion of lung 510. FIG. 9F depicts subject 500positioning and/or zones 520 for treating (e.g., applying oscillationforces using systems and methods described herein) respiratoryafflictions affecting the left and right anterior basil portions oflungs 510. FIG. 9G depicts subject 500 positioning and/or zones 520 fortreating (e.g., applying oscillation forces using systems and methodsdescribed herein) respiratory afflictions affecting the right lateralbasal portion of lung 510. FIG. 9H depicts subject 500 positioningand/or zones 520 for treating (e.g., applying oscillation forces usingsystems and methods described herein) respiratory afflictions affectingthe left lateral basal portion of lung 510. FIG. 91 depicts subject 500positioning and/or zones 520 for treating (e.g., applying oscillationforces using systems and methods described herein) respiratoryafflictions affecting the left and right posterior basal portions oflungs 510. FIG. 9J depicts subject 500 positioning and/or zones 520 fortreating (e.g., applying oscillation forces using systems and methodsdescribed herein) respiratory afflictions affecting the left and rightsuperior basal portions of lungs 510. FIGS. 9A-J depict representationsof how systems described herein may be used as examples of prescriptivepositioning of engines by a caregiver.

FIG. 10 depicts a front perspective view of a representation of anembodiment of a portable high frequency chest wall inner harness 610 ofan oscillator system 600. Known HFCWO systems do not allow for a useradjusting where forces are applied to on the subject. This isproblematic because although some known HFCWO systems may come indifferent sizes to accommodate differently sized subjects, there are fartoo many people of different sizes and so it is impractical to produceenough differently sized systems for all of the differently sizedsubjects. A system 600 which allows for adjustment and/or positioning ofone or more engines and/or one or more groups of engines may allow forprescriptive oscillation or prescriptive positioning of engines by acaregiver. For example, a caregiver may employ means to visualize (e.g.,x-rays) secretions accumulating in the lungs of a subject and thenposition engines appropriately around any areas where secretions areaccumulating. In some embodiments, engines may not only be simply placedadjacent treatment areas but also may be positioned adjacent to areasadjacent to the treatment area to assist in flushing out secretions fromthe subject (e.g., pushing the secretions outside of the subject). Insome embodiments, engines may be positioned in a serpentine pattern on asubject using systems described herein to create what may be describedas a wave effect of oscillation forces.

In some embodiments, a caregiver may prescribe not only the position ofthe engines but also the frequency of one or more of the engines. Thepulse or the beat frequency of one or more of the engines may beadjusted based upon a prescribed frequency. In some embodiments, acaregiver may prescribe or program one or more or all of the engines toturn on or off.

FIG. 10 depicts a front perspective view of a representation of anembodiment of a portable high frequency chest wall inner (or first)harness 610 of an oscillator system 600. In some embodiments, innerharness 610 may be sold in multiple sizes (e.g., 3 or more sizes). Theinner harness may be sold in 3 sizes (e.g., child size, small adultsize, large adult size). In some embodiments, an inner harness may becustom made or sized for a subject. In some embodiments, the innerharness may be formed from a flexible, a pliable or non-rigid material(e.g., as depicted in FIGS. 10-17 and 18-25). A pliable material mayallow the inner harness to fit a wider range of differently physicallysized subjects. The flexible material may allow the inner harness tobunch up around a slighter framed subject once cinched up. As such aninner wearable system may initially hang loosely in some embodiments.

In some embodiments, adjusting the wearable system inner harness mayinclude adjusting fastening systems which couple the wearable system tothe subject. In some embodiments, the wearable system may be adjustableat least across a chest and/or portion of a torso of a subject (e.g., asdepicted in FIGS. 10, 10-17 and 18-23 using friction fittings and straps620). In some embodiments, the wearable system may be adjustable atleast across one or more shoulders of a subject (e.g., as depicted inFIGS. 1, 10-17 and 18-23) or one or more sides of a chest of a subjector a coupling system in a front of a subject (e.g., using zippers orlacing). In some embodiments, the wearable system may be adjustableusing one or more fasteners. In some embodiments, the inner harness mayinclude few or no size adjusting fasteners (e.g., as depicted in FIGS.24-25).

In some embodiments, the inner harness may include a positioning system630. The positioning system 630 may include a coupling method including,for example, a hook and loop coupling system which allows forpositioning and coupling one or more portions of the oscillator system600 to the inner harness. In some embodiments, a coupling method mayinclude straps or pockets (e.g., as depicted in FIG. 6) used to positionengines or other portions of the oscillator system 600.

In some embodiments, engines may be repositioned or adjusted relative toa subject using a system (e.g., by a doctor) which inhibits a subjectfrom repositioning the engines once positioned.

The engines may be positionally coupled or directly attached to thebands and/or system using a number of means known such that the enginesmay be repositioned during use as appropriate for individual subjects.In some embodiments, a hook and loop system may be used to couple theengines to a wearable system such that the engines are repositionable.FIGS. 10-11 depict a front view and a rear view respectively of arepresentation of an embodiment of a portable high frequency chest walloscillator inner harness 610 positioned on a subject. The embodimentdepicted in FIGS. 10-11 includes positioning system 630 wherein thepositioning system includes a plurality of hook and loop strips 630 forcoupling portions of the oscillating system (e.g., engines 640,controller 650, battery 660, etc.) to the inner harness. The strips 630depicted are just an example of a pattern of how the strips may bedistributed on the harness. Specifically the strips may be positioned onthe inner harness to allow positioning engines around the treatmentareas as for example as depicted in FIGS. 9A-J.

In some embodiments, positioning system may include all (orsubstantially all) of the exterior surface of the inner harness (e.g.,as depicted in FIGS. 10-15) being formed from half of a hook and loopsystem such that engines of the system 600 are virtually unlimited, inrelation to the inner harness, as to where the portions may bepositioned (the exterior surface may include a second layer formed fromhalf of a hook and loop system). FIGS. 12-13 depict a front view and arear view respectively of a representation of an embodiment of aportable high frequency chest wall oscillator inner harness positionedon a subject including a second layer 610 a coupled or directly attachedto the inner harness. In some embodiments, positioning system mayinclude all (or substantially all) of the interior surface of the innerharness (e.g., as depicted in FIGS. 16-25) being formed from half of ahook and loop system such that engines of the system 600 are virtuallyunlimited, in relation to the inner harness, as to where the engines maybe positioned (the interior surface may include a second layer formedfrom half of a hook and loop system). FIGS. 16-25 depict various viewsof a representation of an embodiment of a portable high frequency chestwall oscillator inner harness including a plurality of enginespositioned on an interior surface of the inner wearable system.

In some embodiments, they system 600 may include an outer (or second)harness 680 (e.g., as depicted in FIGS. 14-15 and 20-25). The outerharness 680 may be positionable around at least a portion of an exteriorof the inner harness 610. The outer harness may be formed from anelastic, a stretchable or flexible material which when worn compressesor applies pressure or a force or a compressive force to the innerharness and more importantly to any engines beneath the outer harness.Applying pressure to the engines may increase the efficiency of theengines as regards the treatment areas by pressing the engines againstthe subject. Generally the outer harness may function, during use, toimprove transmission of the oscillation force from the engines to thetreatment area of the subject. The outer harness may function to furtheradjust the oscillation force based upon how tightly around the subjectthe outer harness is secured. The outer harness may function to providea compressive force based upon how tightly around the subject the outerharness is secured. The outer harness functions to, in some embodiments,gather and/or tighten an inner harness around a subject to provide atleast a better fit. In some embodiments, a system may include a singleouter wearable harness (e.g., as depicted in FIGS. 20-21). In someembodiments, a system may include two or more outer wearable harnesses(e.g., as depicted in FIGS. 22-25). In some embodiments, a system mayinclude two or more outer wearable harnesses wherein the outer wearableharnesses 680 a-b are different widths (e.g., as depicted in FIG. 26).

The outer harness may allow for fewer sizes of the inner harness to bemade available as the outer harness functions to tighten the enginesagainst the subject such that the inner harness does not need to fit assnuggly. A first end of the outer harness may couple to a second end ofthe outer harness and/or to another portion of the outer harness duringuse (e.g., using hook and loop, buckles, clasps, etc.). At least aportion of the outer harness may be coupled or directly attached (e.g.,permanently fixed (either directly (e.g., sewn to) or indirectly) ortemporarily fixed (either directly (e.g., sewn to 690 as depicted inFIG. 25) or indirectly)) to the inner harness. At least a portion of theouter harness may be coupled or directly attached to the inner harnessin such a way as to allow movement in one or more directions of theouter harness relative to the inner harness (e.g., a double slit cutinto the inner wearable harness through which the outer wearable harnessis threaded through allowing latitudinal and/or longitudinal movement).In some embodiments, one or more portions of the outer wearable harnessmay be coupled or directly attached to the inner wearable harness usingelongated members or loops 700 allowing the outer wearable harness tomove relative to the inner harness while remaining coupled or directlyattached to the inner wearable harness. The loops may allow a subject tomore easily access the outer wearable harnesses during use (allowing thesubject to more easily reach the outer wearable harnesses).

In some embodiments, the outer harness may include any way of providinga compressive force to against one or more of the engines increasing theefficiency of the oscillating force applied to the subject during use(e.g., an outer harness which laces up, ti_(g)htening buckles, etc.).This is in contrast to some currently known vests which are rigid,wherein the rigidity of the vest controls the placement of the enginesduring use.

In some embodiments, one or more engines or portions of the system maybe positioned (e.g., coupled or directly attached to) the outer harness(e.g., to an inner and/or outer surface of the outer harness).

In some embodiments, the wearable system 600 may include multipleengines 640 (e.g., two or more engines, for example, as depicted in FIG.10). The system may include at least four engines 640, at least sixengines 640, at least eight engines 640 or as many engines as necessary(e.g., as prescribed by a physician). In some embodiments, an engine 640(e.g., as depicted in FIGS. 18A-B) may include electric motors, sonicwave generators, electro-mechanic or electro-dynamic vibrators,solenoid, etc. In some embodiments, engines 640 may be positioned incontainers 645 (e.g., as depicted in FIG. 24). Containers 645 may beformed from primarily flexible or pliable materials. The container mayinclude fixation means (e.g., hook and loop) which allow for positioningthe engines 640 as necessary relative to system 600. The containers maysubstantially contain the engines 640 using a zipper and/or a closureflap with a button or hook and loop. In some embodiments, one or morecontainers may include padding (e.g., or be formed from a thickerpliable material). Padded containers may diffuse the oscillation force(e.g., vibration force) over a broader area of a subject, for example,to protect a subject from unintentional injury. The containers may bedisposable, for example, for the purpose of controlling infection (e.g.,after use discard the containers and reuse the engines. Containers mayalso be used for batteries and/or controllers. In some embodiments,engines, controllers, and/or batteries may be saved for reuse and/orrecycling. In some embodiments, an engine 640 (e.g., as depicted in FIG.18C) may include a substantially smooth outer covering such that theengine is easier disinfect the engine before and/or after use.

In some embodiments, the system 600 may include a control unit 650(e.g., as depicted in FIGS. 11, 16, 19-23, and 25). The method mayinclude activating at least the first engine using the control unit 650.The control unit may control activation/deactivation/adjustment of allof the engines of the system 100. In some embodiments, the control unit650 may be couplable to the inner harness 610 (e.g., using a hook andloop strip 630 as depicted in FIG. 11 or positioned in a pocket asdepicted in FIG. 25). The control unit 650 may be directly wired to theengines 640 and/or may be wirelessly coupled or directly attached to theengines. The control unit may use any number of known input methods(e.g., including touchpad). The control unit may be digital or analog.In some embodiments, the control unit may adjust one or more settings ofthe engines. The control unit may adjust the oscillation force output bythe engine. The control unit may adjust an amplitude of the oscillationforce output by the engine. The control unit may adjust a frequency ofthe oscillation force output by the engine. In some embodiments, engineparameters may be adjusted via software (e.g., a phone app) remotely(e.g., Wi-Fi, Bluetooth, etc.).

In some embodiments, the engines 110 may include a frequency range from5 Hz to 20 Hz. In some embodiments, the intensity levels dictate thefrequency which generally runs at 5 Hz for the lowest setting, 13 Hz forthe medium setting and 20 Hz for the highest setting. In someembodiments, engines may be grouped together such that frequenciesproduced by the grouped engines result in a superposition of theproduced frequencies in order to achieve frequencies and/or intensitiesnot achievable under normal operating parameters of the engines. Forexample a superpulse may be achievable, lower frequencies may beachievable. The ability to produce such a variety of differentfrequencies is beneficial for treating different types of lungdisorders. The principle of superposition may be applied to waveswhenever two (or more) waves travel through the same medium at the sametime. The waves pass through each other without being disturbed. The netdisplacement of the medium at any point in space or time, is simply thesum of the individual wave displacements. This is true of waves pulsesor continuous sine waves. For example, two sinusoidal waves with thesame amplitude and frequency can add either destructively orconstructively depending on their relative phase. The phase differencebetween the two waves may increase with time so that the effects of bothconstructive and destructive interference may be seen. When the twoindividual waves are exactly in phase the result is large amplitude.When the two waves become exactly out of phase the sum wave is zero.

For example, bronchiectasis is a condition in which damage to theairways causes them to widen and become flabby and scarred preventingthe airways from clearing mucus (mucus which is typically voluminous andrelatively thin). In contrast cystic fibrosis is a genetic disorder thatresults in at least difficulty breathing and an inability to clear thelungs of mucus (mucus which is typically relatively thick). Differentconditions result in different mucus and/or debris in a subject's lungswhich may benefit from different frequencies which may be prescribed by,for example, a physician.

In some embodiments, a method may include modifying the treatmentparameters (e.g. amplitude, frequency, and time for each engine). Eachengine may be programmed, using physical hardware control unit orsoftware to run a custom cycle. This programming may be performedaccording to each subject. In addition, the system may provide aphysician or caregiver with the ability to prescribe a defined treatmentand/or to inhibit the user from modifying the treatment settings (e.g.lock-out feature w/password, pin code, etc.). Each of the motors may beindividually programmable (e.g., length of run time, type of vibration(e.g., constant, pulsing, etc.), frequency, amplitude, etc.).

In some embodiments, the method and/or system may adaptively modify thetreatment protocol based on subject and/or physician feedback. Forexample, a subject enters mucus secretion levels after each treatmentand the system adaptively optimizes the treatment settings over time.

In some embodiments, the method and/or system may monitor complianceinformation. For example, the system could monitor (in real-time) thetreatment for each subject, including parameters run, time of treatment,time of day and any subject feedback. This could be accomplished throughhardware or software (e.g. a web-based subject/physician portal whichlinks w/Bluetooth to each vest). The information may be provided to thesubject, physician, insurance company or other third-party.

In some embodiments, the system 600 may include at least one battery660. The method may include powering the engines 640 using one or morebatteries 660 coupled or directly attached to the inner harness of thewearable system. In some embodiments, a battery 660 may include arechargeable battery and/or a disposable battery. The battery 660 mayinclude two or more batteries. The batteries 660 may be easily swappedout whether rechargeable or disposable. The battery 660 may be coupledor directly attached to the system 600 (e.g., using a hook and loopstrip 630 as depicted in FIG. 11). The system may include an adaptersuch that when necessary the system may be coupled or directly attachedto an electrical outlet (e.g., through an electrical adapter ifnecessary). The system 100 may be powered using AC or DC power sourcessuch that the system may be powered using virtually any known powersource currently available.

In some embodiments, the system 600 may include a system of electricalcouplings 670. Electrical couplings 670 may couple control unit 650and/or battery 660 to engines 640 (e.g., as depicted in FIGS. 10-13).The electrical couplings may run on an exterior surface of the innerharness (e.g., as depicted in FIGS. 10-11). The electrical couplings mayrun under a second layer 610 a of inner harness 610 (e.g., as depictedin FIGS. 12-13) with coupling ends extending out of openings in thesecond layer 610 a. In some embodiments, at least some portions of theelectrical couplings may be bound or bundled together (e.g., such thatthe electrical couplings are easier to separate from the rest of thesystem 600 for disposal or recycling. In some embodiments, theelectrical couplings (e.g., wires) may be sewn in to the disposableinner wearable system. The inner wearable system may include conduits675 (e.g., fabric, impervious materials (e.g., plastics) as depicted inFIG. 24) for wires coupled or directly attached to and/or sewn into theinner wearable system (e.g., to electrically connect a battery and/or acontroller to at least one of the plurality of engines). In someembodiments, conduits 675 may be positionable relative to the innerwearable system. The conduits may be connected to the inner wearablesystem using hook and loop systems. The wires may provide multipleconnection points for the plurality of engines so that the plurality ofengines are repositionable while still using the wires in the fabricconduits.

In some embodiments, the system may be self-contained. The system may beself-contained such that a subject may wear the system 600 and movefreely and in a substantially unrestricted manner The system may beself-contained such that a subject may wear the system 600 whilefunctioning and not physically connected to any external devices (e.g.,air pumps).

In some embodiments, all, substantially all, or at least one portion ofthe system 600 may be disposable or recyclable. Making portions of thesystem 600 disposable may be disposable due to, for example, that muchof the equipment used in healthcare environments which comes into directcontact with subjects is disposable (or covered by disposable sheaths).It is typically much easier and/or less expensive to throw awayequipment which comes into contact with subjects as opposed to cleaningthe equipment. In some embodiments, the inner wearable harness isdisposable. In some embodiments, the outer wearable harness isdisposable. In some embodiments, at least some of the plurality ofengines are disposable. In some embodiments, the inner and/or outerharness and the engines may be disposable.

In some embodiments, one or more portions of the system 600 arerecyclable. For example self-contained portions of the system (e.g.,engines 640) may be recyclable in order to reduce waste.

In some embodiments, one or more portions of the systems describe hereinmay include antimicrobial coatings (e.g, in fabrics of the vests). Insome embodiments, one or more portions of the systems described hereinmay be able to withstand one or more common medical sterilizationtechniques (e.g., high temperature, high pressure, chemical, etc.). Insome embodiments, one or more portions (e.g, in fabrics of the vests orthe containers for one or more engines) may include an imperviousmaterials, coatings, or linings such that one or more portions of thesystem are protected from or at least inhibited from exposure to one ormore contaminants. For example, a lining or material may besubstantially impervious to water or blood borne pathogens orcontaminants. For example, a lining or material may be substantiallyimpervious to gasses and/or air borne pathogens or contaminants. In someembodiments, a container such as a positionable engine container 645 mayinclude an impervious or impermeable lining which inhibits contaminationof an engine positioned in the container such that the engine may bemore easily recycled.

In this patent, certain U.S. patents, U.S. patent applications, andother materials (e.g., articles) have been incorporated by reference.The text of such U.S. patents, U.S. patent applications, and othermaterials is, however, only incorporated by reference to the extent thatno conflict exists between such text and the other statements anddrawings set forth herein. In the event of such conflict, then any suchconflicting text in such incorporated by reference U.S. patents, U.S.patent applications, and other materials is specifically notincorporated by reference in this patent.

Further modifications and alternative embodiments of various aspects ofthe invention will be apparent to those skilled in the art in view ofthis description. Accordingly, this description is to be construed asillustrative only and is for the purpose of teaching those skilled inthe art the general manner of carrying out the invention. It is to beunderstood that the forms of the invention shown and described hereinare to be taken as the presently preferred embodiments. Elements andmaterials may be substituted for those illustrated and described herein,parts and processes may be reversed, and certain features of theinvention may be utilized independently, all as would be apparent to oneskilled in the art after having the benefit of this description of theinvention. Changes may be made in the elements described herein withoutdeparting from the spirit and scope of the invention as described in thefollowing claims.

What is claimed is:
 1. A system, comprising: an inner wearable harnessworn, during use, on a torso of a subject; a plurality of engines whichwhen activated apply an oscillation force to at least one treatment areaof the subject, wherein at least one of the plurality of engines isreleasably couplable to the inner wearable harness such that the atleast one of the plurality of engines is selectively positionablerelative to the subject using a positioning system, wherein thepositioning system allows positioning the at least one of the pluralityof engines such that the oscillation force is applied to at least one ofthe treatment areas of the subject, wherein the oscillation forcemobilizes, during use, at least some secretions in an airway within thesubject at least adjacent the treatment area, and wherein the innerwearable harness comprises fastening systems which couple, during use,the wearable system to the subject, and wherein as the fastening systemsare activated the fit of the wearable harness is adjusted to thesubject; an outer wearable harness worn, during use, on a torso of asubject, wherein a portion of the outer wearable harness is coupled tothe inner wearable harness; and at least one sealable container in whichat least some of the plurality of engines are positioned in, during use.2. The system of claim 1, wherein the outer wearable harness, whenactivated, adjusts the oscillation force applied by at least some of theactivated plurality of engines to the treatment area.
 3. The system ofclaim 2, wherein the outer wearable harness, when activated, adjusts theoscillation force applied by at least some of the activated plurality ofengines by compressing or applying pressure to the activated enginessuch that the activated engines are pressed against the subject to moreeffectively convey the oscillation force to the treatment area.
 4. Thesystem of claim 1, wherein at least a majority of the inner wearableharness is formed from a flexible material.
 5. The system of claim 1,wherein the outer wearable harness comprises an elastic material.
 6. Thesystem of claim 1, wherein the outer wearable harness comprises aflexible material.
 7. The system of claim 1, wherein at least some ofthe plurality of engines are releasably coupled to the inner wearableharness using a hook and loop system.
 8. The system of claim 1, whereinat least some of the plurality of engines are releasably coupled to theouter wearable harness.
 9. The system of claim 1, wherein an amplitudeof the oscillation force is adjustable.
 10. The system of claim 1,wherein a frequency of the oscillation force is adjustable.
 11. Thesystem of claim 1, further comprising a control unit which activates,during use, the plurality of engines.
 12. The system of claim 1, whereinwhen the outer wearable harness adjusts, during use, a fit of the innerwearable harness to the subject's torso.
 13. The system of claim 1,wherein the positioning system comprises a plurality of pockets.
 14. Thesystem of claim 1, wherein the outer wearable harness comprises at leastone stretchable band, and wherein a first portion of the outer wearableharness is couplable to a second portion of the outer wearable harness.15. The system of claim 1, wherein the outer wearable harness comprisesat least one stretchable band coupled to the inner wearable harness, andwherein a first portion of the outer wearable harness is couplable to asecond portion of the outer wearable harness.
 16. The system of claim 1,wherein a frequency of at least one of the plurality of engines isadjustable.
 17. The system of claim 1, wherein a frequency of at leastone of the plurality of engines is adjusted based upon a prescribedfrequency provided by a caregiver.
 18. The system of claim 1, furthercomprising a control unit, wherein the control unit assesses, duringuse, where to reposition the at least some of the plurality of enginesafter data is gathered after an initial placement.
 19. The system ofclaim 1, further comprising a control unit, wherein the control unitadjusts, during use, an amplitude of the oscillation force.
 20. Thesystem of claim 1, further comprising a control unit, wherein thecontrol unit adjusts, during use, a frequency of the oscillation force.21. The system of claim 1, wherein the sealable container is formed byat least a portion of the outer wearable harness and at least a portionof the inner wearable harness.